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Cardiac and Vascular Catheterization Laboratory

Unit Specifics

  • State of the art digital lab and adult patients with:
    • Coronary artery disease
    • Peripheral vascular disease
    • Valvular disease
    • Congestive heart failure
    • Chronic pain
    • Electrical conduction defects

Facility and Technology

  • 3 Suites
  • State of the art digital cardiac and vascular imaging
  • Flat plate imaging
  • Images store via a computerized network
  • Active interventional radiology services
  • Computerized charting

Procedures

  • Heart catheterization
  • Permanent pacemaker insertion
  • Percutaneous transluminal angioplasty
  • Biventricular pacemakers for coronary, renal and peripheral
  • Thrombus extraction vascular disease
  • Stent implantation
  • Ablation therapy-multiple modalities
  • AICD implantations
  • TIPSS procedures
  • Kyphoplasty
  • Vertebroplasty
  • Intravascular Embolization
  • Venous Access

Staffing

  • Team consists of:
    • Registered Nurses
    • Radiology Technologists
    • Cardiovascular Technologists

Career and Educational Opportunities

  • Ability to cross-train in scrub, x-ray and monitoring roles
  • Educational funds to attend conferences and seminars
  • No holidays or weekends; except call
  • Monthly cardiac cath conference

Collaboration and Teamwork

  • Relaxed atmosphere
  • Autonomous and highly trained staff
  • Self-scheduling and call rotation
  • Excellent collaborative relationship between Cardiologists, Radiologists, and Staff

Emergency Department

Unit Specifics

  • 27 Bed Emergency Department private rooms, treating a wide variety of patients; from the non-emergent patient to the critically ill patient
  • 6 Bed Fast Track for lower acuity patients
  • 5 Recliner Team Triage Rapid Medical Exam Treatment Area
  • 24-hours staffing with Emergency Department experts including Board Certified Emergency Physicians, Advanced Practice Clinicians, Registered Nurses, and ED Technicians
  • 5-bed Observation Unit – Staffed with a Registered Nurse and a CNA
  • Over 45,000 visits a year

Staffing

  • Registered Nurse
  • Advanced Practice Clinicians
  • Board Certified Emergency Physicians

Staffing Ratios

  • Variable from 1:1 to 1:6 depending on patient acuity

Ancillary Staff

  • ED Technicians
  • Advanced ED Technicians/Paramedics

Career & Educational Opportunities

  • Emergency Nurses Association Lantern Award Designated ED 2020-2023
  • Staff education through ongoing in-services, self-paced learning packets, outside educational programs
  • Individualized orientation with qualified preceptors
  • Individualized opportunities for clinical growth and expertise
  • New Graduate Nurse Residency Program

Intensive & Cardiovascular Care Unit

Unit Specifics

  • The Intensive Care Unit is a 24-bed unit (16 ICU + 8 CVU), caring for patients requiring in-depth monitoring, as well as patients requiring cardiac and vascular care and support in a critical care setting.

Patient Population

  • Multi-System Patients
  • Respiratory Compromised Patients
  • Acute MI
  • Critically Ill patients requiring additional support and monitoring
  • Cardiac Catheterization Procedures, diagnostic and interventional
  • Vascular lab procedure
  • Complex post-operative patients

Staffing Ratios

  • Based upon an acuity system

Collaboration and Teamwork

  • Critical Care Medical Director
  • Dedicated, highly trained, experienced and respected Critical Care Nurses
  • Respiratory Therapy
  • Integrated Case Managers
  • Social Services
  • Monitor Tech Support

Equipment and Technology

  • Pre and postoperative care of the open-heart surgery patient, in the Universal Bed Concept: Cardio-One
  • Vasoactive Medication Management
  • Intra Aortic Balloon Pump
  • CRRT (continuous renal replacement therapy)
  • Ventilators
  • Invasive Hemodynamic Monitoring
  • Specialized Infusion Pumps

Career and Educational Opportunities

  • Staff education through ongoing in-services, self-paced learning packets, outside the educational program
  • Individualized orientation with qualified preceptors
  • Critical care educator at the bedside
  • Monthly physician lectures
  • New Graduate Program
  • Tuition Reimbursement
  • Variety of self-learning modules available

Medical/Oncology

Unit Specifics

  • This 46-bed unit’s primary purpose is to provide acute nursing care to all medical, infectious, geriatric and oncology patients 16 years of age or older.
  • Patients are either direct admissions from physicians’ offices, the emergency department, intra-hospital transfer and inter-organizational transfer, such as Minden Emergency/Urgent Care admissions.
  • RN assessment is initiated within twelve hours with reassessment and ongoing interventions per standards. Reassessments and interventions are individualized per patient needs, utilizing the nursing process, collaborating with physicians and ancillary departments.

Staffing

  • The team consists of Registered Nurses, Certified Nurse Assistants and Unit Clerks.
  • Ratio of nurse to patient is approximately 5/6 patients; we have 24/7 CNA coverage, with the CNA taking 7-9 patients on days and 8-10 on nights. Average length of stay is 3 days.

Education

  • To keep up with the ever-changing medical field and to expand skill levels, we provide ongoing educational opportunities for our nursing staff.

Career Opportunities

  • Nurse Apprentice allows for potential placement as a new graduate nurse. We hire new graduate nurses twice a year.  We have training programs for our graduate nurses to ensure a successful transition to the RN role.

Medical Imaging/Radiology

Unit Specifics

  • Diagnostic X-ray and Fluoroscopy– Carson Tahoe Main Campus has fully digital departments which include equipment from GE, Philips, CareStream, (Scoliosis Stitching Software), Siemens, and Ziehm. Mixtures of outpatient and inpatient services are performed daily. Outpatient X-ray facilities: includes Sierra Surgery and Imaging, Eagle Medical Center and Minden. A 7 day a week Urgent Care facility also has X-ray capabilities if warranted by the treatment provider.
  • Computerized Tomography – We currently operate a single slice and 4-slice GE CT’s in two different outpatient clinics and in the Regional medical center we have an 8-slice and 16-slice GE scanners. These are busy departments with the Regional medical center staffed 24/7.
  • MRI – 1.5T and 3T Wide bore GE/Philips scanners, with exciting software in a very aesthetically pleasing suite. Mixtures of inpatient and outpatient procedures are performed daily. Regular staffing from 7 am - 10 pm with on-call coverage 24/7 for emergencies and Outpatient 7:30 am - 6 pm Monday - Saturday.
  • Nuclear Medicine – 2 dual head cameras by Philips. A busy department that staffs 3 technologists daily, performing an array of services general nuclear medicine, nuclear cardiology, nuclear endocrinology, and Brach therapy.
  • Ultrasound – GE Logic E9 ultrasound machines help our team perform various general and vascular procedures including abdominal, OB/GYN, and vascular studies.
  • Mammography – A state of the art breast center which includes Digital 2D and 3D mammography and bone density.
  • Our PET/CT Department at Carson Tahoe Health has a Siemens Biograph mCT Scanner which is conveniently located at our Outpatient Imaging Facility at Eagle Medical Center, open M-F 07:30am to 4:00 pm.

Staffing

  • The team consists of registered technologists, clerical personnel, PACS administrators, student technologists and transporters.

Education

  • Continued Education is offered online.

Surgical Services

Unit Specifics

  • The Surgical Unit has 4 state of the art surgical suites and 2 CVOR suites providing complex surgical care along with 14 PACU Phase I bays and 10 Phase II/Pre-Op bays providing individualized patient care based on the complexity of acuity.

High Tech Skills Necessary

  • Ability to work in an environment that is self-directed, fast-paced, yet relies on working as a team with other healthcare providers

Surgery

  • Knowledge of AORN Standards
  • Knowledge of surgical equipment and instrumentation
  • Knowledge of decontamination, processing and sterilization of surgical instrumentation
  • Perianesthesia
  • Knowledge of ASPAN Standards
  • Knowledge of patient assessment and discharge planning
  • Knowledge of respiratory and hemodynamic monitoring equipment

Communication and Collaboration

  • The patient care team is composed of the Circulating RN, Scrub RN or Surgical Technologist and Perianesthesia Nurse working in collaboration with the Surgeon and the Anesthesiologist to develop a plan of care consistent with the mission, vision, and philosophy of the Carson Tahoe Regional Medical Center.

Career & Educational Opportunities

  • Career Advancement Program (Cap) & Tuition Reimbursement
  • Staff education through ongoing in-services, self-paced education modules, educational seminars and conference

Surgical/Orthopedic Unit

Unit Specifics

  • This twenty-seven (27) bed Surgical /Orthopedic unit provides skilled specialized nursing care to the postoperative patient.  Patients access the Surgical/Orthopedic unit as scheduled elective surgical admits, emergency room admits, intra-hospital transfers, direct admits from physician office, and intra-organizational transfers. Patients are often a higher acuity level due to their complex unique surgical needs. 
  • Common surgeries cared for include, but are not limited to, vascular procedures, total joint replacement, total joint revisions, spinal surgeries, thoracic cases with chest tube placement, cases utilizing robotics, open and laparoscopic abdominal and urologic cases, and traumatic fracture repair.

Staffing

  • The department has employees of different skill and educational levels, and embraces the team approach to patient care.
  • Registered Nurses (RNs) are the primary caregivers and are supported by Certified Nursing Assistants (CNAs), unit clerk, and Nurse Apprentices.
  • The nurse to patient ratio averages from 4:1 to 5:1 during the day and 5:1 to 6:1 at night with 2-3 nursing assistants to support the nursing staff
  • A full-time unit clerk helps facilitate the organization of the unit
  • Self-scheduling is offered.

Education

  • To keep up with the ever-changing medical field and to expand skill levels, we provide ongoing educational opportunities for our nursing staff.

Career Opportunities

  • With a vast assortment of patient types and medical-surgical needs, the variety of this unit provides a solid knowledge base for those nurses who wish to enhance their skills and embrace challenges
  • We also offer an excellent preceptorship for Graduate Nurses and a solid orientation for those who are already experienced
  • The unit offers Nurse Apprenticeships twice per year.
  • On this unit, you will learn a variety of skills including, but not limited to, wound care, wound vac placement, care of surgical incisions and drains, application and indications for orthopedic devices, splints, and braces, administration of supplemental nutrition via TPN or GI tube, safe patient handling, and much more.

Telemetry Unit

Unit Specifics

  • The 27-bed Telemetry Unit provides critical progressive nursing care to patients needing continuous cardiac monitoring.
  • Patients are either direct admissions from physicians’ offices, the emergency department, intra-hospital transfer and inter-organizational transfer and extended care facilities.
  • The primary diagnosis may include but is not limited to: Cardiac Patients with CHF, unstable angina, cardiac arrhythmias, respiratory patients with impending respiratory failure; stroke patients; medical/surgical patients requiring continuous cardiac monitoring and/or treatment; post-partum obstetric patients and adolescent patients requiring continuous cardiac monitoring and treatment.
  • Utilizing the nursing process, the Telemetry staff collaborates with physicians, patients and ancillary departments to facilitate a continuum of care.

Staffing

  • The team consists of Registered Nurses, Certified Nurse Assistants, Unit Clerks and Monitor Techs.
  • Ratio of nurse to patient is approximately 4/5 patients; We have 24/7 CNA coverage. The average length of stay is 2-3 days.

Education

  • To keep up with the ever-changing medical field and to expand skill levels, we provide ongoing educational opportunities for our nursing staff.

Career Opportunities

  • We offer Nurse Apprentice opportunities, as well as New Graduate Nurse positions yearly; successfully placing our nurse apprentices into graduate nurse positions within the Unit. We have training programs for our graduate nurses to ensure a successful transition to the RN role.

Women and Children’s Center

Unit Specifics

  • The Women & Children’s Center consists of 12 beds in the OB Department; including 8 private labor, delivery, recovery, and postpartum rooms (LDRP), 4 private post-delivery rooms, 1 operating suite with a recovery area, and a stabilization nursery.
  • The pediatric unit has 8 private rooms with centralized monitoring, a playroom, and a treatment room.

Services Offered

  • LDRP
  • Operating suite located in the OB department
  • Full-service childbirth education program
  • Lactation consultants on staff
  • Baby-Friendly Designation
  • Couplet care for all newborns and families
  • Home Visit Program for the new mom and infant
  • Fully equipped nursery for stabilization and transport if necessary
  • Centralized monitoring – OB Department & Peds
  • State-of-the-art equipment
  • 3 bed OB Triage room
  • Breastfeeding warm-line, in-patient and outpatient Lactation Consultation, and community Breast Feeding support groups.

Education

  • Active nursing staff education and training programs including newborn stabilization, mother/baby, and baby-friendly care with training to Labor and Delivery Nursing care including Electronic Fetal Monitoring, STABLE, and NRP.
  • To keep up with the ever-changing medical field and to expand skill levels, we provide ongoing educational opportunities for our nursing staff based on Perinatal Best Practices.

Career Opportunities

  • We offer Apprentice Nurse positions, as well as New Graduate nurse positions yearly, successfully placing several of our apprentice nurses into graduate nurse positions within Women & Children’s and Pediatrics. We have training programs for our graduate nurses to ensure a successful transition to the RN role.

Carson Tahoe Sierra Surgery Postop Unit

Unit Specifics

  • This fifteen (15) bed surgical unit provides skilled, specialized nursing care to the postoperative patient.  Patients access the PostOp unit at Sierra Surgery as elective surgeries or direct admit, and are often a lower level of acuity.
  • Patients typically stay 23 hrs to 3 days. Common surgeries cared for include, but are not limited to, urologic and gynecologic procedures, total joint replacement, spinal surgeries, open and laparoscopic abdominal cases, cosmetic and reconstructive surgeries, and bariatric cases including gastric sleeve cases.

Staffing

  • The department has employees of different skill and educational levels, and embraces the team approach to patient care.
  • Registered Nurses (RNs) are the primary caregivers and are supported by Certified Nursing Assistants (CNAs), and Nurse Apprentices.
  • The nurse to patient ratio is 5:1 during the day and 5:1 to 6:1 at night with 1 nursing assistant to support the nursing staff
  • Self-scheduling is offered.

Education

  • To keep up with the ever-changing medical field and to expand skill levels, we provide ongoing educational opportunities for our nursing staff.

Career Opportunities

  • With a vast assortment of patient types and medical-surgical needs, the variety of this unit provides a solid knowledge base for those nurses who wish to enhance their skills and embrace challenges
  • We also offer an excellent preceptorship for Graduate Nurses and a solid orientation for those who are already experienced
  • The unit offers Nurse Apprenticeships twice per year.
  • On this unit, you will learn a variety of skills including, but not limited to, wound care, care of surgical incisions and drains, application and indications for orthopedic devices, splints, and braces, colostomy care, safe patient handling, thorough postoperative patient education and much more.